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A Potential Prion Therapy Focuses Attention on Protein Conversion
31 October 2003. British researchers report in today’s Science that they have managed to prevent and even reverse clinical manifestations of prion disease. Surprisingly, they did it not by eliminating deposits of abnormal prions, but by depleting normal prion protein. Beyond the therapeutic implications, this result suggests that neurotoxicity in the disease is a function of the protein’s conversion process rather than its final product.

Prion diseases ranging from Creutzfeldt-Jacob to mad-cow are caused by prion proteins (PrPc) being misfolded, or so the story goes. But do these abnormal proteins (PrPSc) cause neurodegeneration? There are some bits of evidence to the contrary, even aside from the fact that some human prion diseases feature little or no detectable PrPSc, the authors write. For example, the accumulation of PrPSc does not necessarily correlate with disease symptoms in animal models, and the addition of PrPSc to brain tissue that does not also have endogenous or transgenic PrPc will not induce neurodegeneration in this tissue.

Still, the conversion of PrPc to some other form appears to be critical for the disease, so John Collinge, Giovanna Mallucci, and colleagues at the Institute of Neurology in London decided to target PrPc directly. The researchers generated mice transgenic for a prion protein gene that increases the amounts of PrPc produced, but also harboring a transgene for the enzyme Cre recombinase, which shuts down the expression of the PrP transgenes. The beauty of this experimental system is that a neurofilament heavy chain promoter does not allow Cre to be expressed until the mice are 10 to 12 weeks of age, and limits expression to neurons. Thus, the mice overproduce PrPc in both neurons and glia until about 12 weeks of age, after which Cre shuts this expression down in neurons.

The experiment began with the inoculation of mice with scrapie prions at three to four weeks of age. At 12 weeks of age, both PrP and Cre/PrP transgenic animals show pathological evidence of infection, though they still have minimal spongiosis and no behavioral signs of disease. At that point, PrP transgenic mice (lacking the Cre enzyme to shut down PrP in neurons) proceed to develop spongiosis and die around 20 weeks of age.

By contrast, at last count, mice with the Cre gene were still going strong—and asymptomatic—at an average 60 weeks of age. This survival correlates with a shutdown of PrPc in neurons, but not in glia, and a rescue of neurons from degeneration. Surprisingly, however, PrPSc continues to accumulate in these asymptomatic mice. The reason appears to be that glial conversion of PrP is not shut down. What’s more, the little bit of spongiosis that had begun in mice at 12 weeks of age was reversed when Cre expression kicked in.

"Our results…argue against direct neurotoxicity of PrPSc," write the authors. They add that "[I]t appears that the conversion of PrPc to disease-related forms must occur within neurons to be pathogenic, consistent with the possibility that a toxic intermediate is generated within neurons during the conversion process."—Hakon Heimer.

Reference:
Mallucci G, Dickinson A, Linehan J, Klohn PC, Brandner S, Collinge J. Depleting neuronal PrP in prion infection prevents disease and reverses spongiosis. Science. 2003 Oct 31;302(5646):871-4. Abstract

 
Comments on News and Primary Papers
  Comment by:  Einar Sigurdsson (Disclosure)
Submitted 4 November 2003  |  Permalink Posted 4 November 2003

This is an elegant study that shows the importance of studying further the biological role of PrPC, and the intermediates that are formed during the conversion of PrPC to PrPSc. It is interesting to compare these findings to the Alzheimer's field, where little neurotoxicity is associated with Aβ plaques in mouse models, and certain Aβ species may be responsible for Aβ-induced neurotoxicity.

View all comments by Einar Sigurdsson

  Comment by:  Charles Glabe, ARF Advisor
Submitted 10 November 2003  |  Permalink Posted 10 November 2003

A requirement for intraneuronal PrPsc conversion in prion pathogenesis: What questions does this raise about the mechanism of AD pathogenesis?

The recent report by John Collinge and colleagues provides important new insight into the mechanisms of pathogenesis of prion disease, and raises some interesting questions about the corresponding mechanism for Alzheimer’s disease (AD) pathogenesis. They report that specifically depleting PrPc in neurons at 10-12 weeks reversed the early spongiform degeneration and dramatically prevented neuronal death and clinical disease, even though PrPsc accumulated extracellularly to the same level observed in diseased control animals. These results indicate that prion pathogenesis is intimately associated with the conformational conversion of PrPc to PrPsc in neurons, and that the extracellular accumulation of PrPsc is not toxic per se.

Do these results have heuristic value as an analogy for AD pathogenesis? AD and prion pathogenesis share some interesting pathogenic...  Read more


  Comment by:  Mary Reid
Submitted 2 November 2003  |  Permalink Posted 19 November 2003

This study finding that depletion of normal prion protein prevents or reverses the clinical manifestations of Creutzfeldt-Jacob disease is interesting.

Is it overexpresed as is APP in Alzheimer's disease?

If the study by Kniazeva, Orman and Terranova finding that PDGF is an inhibitor of PrP is replicated in neuronal tissue, I wonder whether we could look at reasons why PDGF signaling may be inhibited as a cause of prion diseases.

I had been looking at the fact that chlostridium difficile toxin B inhibits CDC42, and wondered if that would be an alternative to Gleevec for the treatment of Alzheimer's disease. With that in mind, is it too far a stretch to question a C. difficile involvement in the development prion disease? Could inhibition of CDC42 result in reduced inhibition of PrP mRNA by PDGF? Garcia-Lechuz et al. find that extra-intestinal infections caused by C. difficile occurred without concomitant...  Read more

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